Many patients who develop liver cancer have had cirrhosis for a long time. If a patient with cirrhosis gets worse for no known reason, doctors should suspect that liver cancer may be the cause and do the tests needed to find out if this is the case.
Liver cancers can sometimes be found using a blood test for a protein called AFP (alpha-fetoprotein). It is normal for AFP to be found in the blood of unborn babies, but it goes away shortly after birth. If it is found in the blood of adults they may have liver cancer (or another kind of cancer).
Tests for AFP may be used to look for early tumors in people at high risk for liver cancer. Some tumors, though, do not make much of this protein. So by the time the AFP is high enough to be found, the tumor may be too large to be removed or may have spread outside the liver. Some liver diseases that are not cancer can also raise AFP levels.
Ultrasound is a test that uses sound waves to make pictures of organs inside the body. For an ultrasound, you lie on a table while a wand is moved along the skin over the part of the body being looked at. Ultrasound is sometimes used in people with certain liver cancer risk factors to help find cancers earlier. Any masses (tumors) seen in the liver can then be tested for cancer if needed.
Who should be tested?
People at higher risk for liver cancer may be helped by screening. (Screening is testing people for a disease before they have symptoms.) Many doctors recommend testing for certain high-risk groups. These include people with cirrhosis, especially if it is so bad that the patient is waiting to get a liver transplant. Otherwise a cancer may start during the wait and become so advanced that it can't be cured. Having liver cancer may also move the person up on the transplant waiting list.
Some people with chronic hepatitis B or C infections should also be screened, like those with liver cancer in the family. For other people at higher risk, the benefits of screening may not be as clear. If you think you are at high risk for liver cancer, talk to your doctor about whether screening is a good idea for you.
*Information from the American Cancer Society.